Performance Physical Therapy Prof

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PERFORMANCE PHYSICAL THERAPY PROF

Practice address

215 E Jackson Blvd
Suite B
Spearfish, SD 57783-2176

Phone

(605) 722-6880

Fax

(605) 722-6889

NPI assigned

Jan 31, 2007

Last updated

Apr 6, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tammy J Tjaden, BS, ATC

Title

Practice Manager

Phone

(605) 722-6880

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tim J Kudlock, PT

  • Physical Therapist
  • Spearfish, SD
  • NPI 1720125438
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1568509289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E JACKSON BLVD",
            "address_2": "SUITE B",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577832176",
            "telephone_number": "605-722-6880",
            "fax_number": "605-722-6889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E JACKSON BLVD",
            "address_2": "SUITE B",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577832176",
            "telephone_number": "605-722-6880",
            "fax_number": "605-722-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PHYSICAL THERAPY PROF",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "TJADEN",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "605-722-6880",
        "authorized_official_credential": "BS, ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD SD",
            "identifier": "0041171",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peak Chiropractic PLLC
• Peak Motion Physical Therapy, Inc
• Jason Randall Peldo, CRNA
• Julie Peldo, CCC-SLP
• Piper A Perez, BS
• Donna L. Peters, C.N.P.
• Taira Peterson
• Elaine Victoria Petry, O.D.
• Rachel Pettersen, LPC-MH, QMHP
• Natalie Louise Polei, RD

• Physical Therapy Clinic/Center in Spearfish, SD
• Providers in Spearfish, SD by specialty
• Physical Therapy Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.